Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 34331 | KY |
NPI | 1013907369 |
---|---|
Provider Name | Mrs. Jennifer A Fuson |
First Address | Lexington, KY 40503-1489 |
Second Address | Lexington, KY 40503-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 03/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64343312 | (05) | KY |